Provider Demographics
NPI:1265691083
Name:VILEN, JANNA J (MD)
Entity type:Individual
Prefix:DR
First Name:JANNA
Middle Name:J
Last Name:VILEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JANNA
Other - Middle Name:JO
Other - Last Name:JOHANNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4126 SPRING HILL RD
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-6689
Mailing Address - Country:US
Mailing Address - Phone:651-270-6452
Mailing Address - Fax:
Practice Address - Street 1:4126 SPRING HILL RD
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-6689
Practice Address - Country:US
Practice Address - Phone:651-270-6452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN50865207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT80268OtherMONTANA LICENSE